塞米普利马布诱导的大肠炎导致低血压休克:一个案例报告和文献综述
Saeed S Graham1, Kena J Lemu1, Victoria Mofopefoluwa Thomas2
1Brody School of Medicine, Department of Internal Medicine East Carolina University Greenville North Carolina USA.
概括
像Cemiplimab这样的免疫检查点抑制剂可以导致严重的大肠炎,一种可能危及生命的胃肠道炎症. 早期诊断和皮质类固醇治疗对于治疗癌症患者这种不良事件至关重要.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 胃肠病学 胃肠病学
背景情况:
- 免疫检查点抑制剂 (ICI) 广泛用于癌症治疗.
- ICI可能会导致严重的免疫相关不良事件,包括胃肠道炎症.
- 塞米普利马布是一种用于高级皮肤状细胞癌 (cSCC) 的ICI.
研究的目的:
- 报告一个Cemiplimab诱导的大肠炎病例.
- 为了突出严重并发症的可能性,如低血压休克.
- 强调迅速管理战略的重要性.
主要方法:
- 一个83岁的男性患有cSCC,接受Cemiplimab治疗的病例报告.
- 严重腹,低血压休克和急性功能衰竭的临床表现.
- 诊断工作包括内镜和组织病理学,然后用高剂量普雷尼松治疗.
主要成果:
- 塞米普利马布治疗导致严重的结肠炎.
- 患者出现了低血压休克和急性功能衰竭.
- 高剂量的普雷尼松导致了症状的快速改善和恢复.
结论:
- 塞米普利马布可以诱导严重的结肠炎,这是一个严重的免疫相关的不良事件.
- 早期内镜评估和及时的皮质类固醇治疗对于有效的管理至关重要.
- 在接受ICI治疗的患者中,对胃肠道症状的警监测至关重要.
相关概念视频
Inflammatory Bowel Disease I: Ulcerative Colitis
348
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
348
Blood Pressure Imbalances and Circulatory Shock
1.0K
Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
1.0K
Inflammatory Bowel Disease IV: Pharmacological Management
205
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
205
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
432
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
432
Drugs for Treatment of Ulcerative Colitis in IBD
244
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
244
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
278
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
278


